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Wounds may be classified as either being acute or chronic in nature. Acute wounds may be defined as, ‘those healing as anticipated’ and chronic wounds as, ‘Wounds that are failing to heal as anticipated or that have been stuck in any one phase of wound healing for a period of six weeks or more’.

How wounds are treated?

The most common approach to the assessment, preparation and management of wounds is known as TIME. The TIME principle works as follows:

Tissue
Health care professionals will identify the types of tissue within the wound bed. All unwanted dead tissue will be removed.

Inflammation/Infection
Health care professionals will identify the cause of inflammation/infection if present and will administer the appropriate treatment.

Moisture
Research has shown that wounds heal better when the wound is kept moist by use of an appropriate dressing. The most effective treatment is to achieve a balance where the wound is moist but not saturated. Healthcare professionals will select the most appropriate dressing for the wound.

Edges
How the skin edges can be protected from further damage as a result of any excess exudate. It is important that the edges of a wound are kept healthy to reduce the risk of skin breakdown and infection.

In order to aid with the M and E parts of the TIME principle, various products, dressings and skin protection may be used on a wound.

How wounds affect quality of life?

A patient's ‘quality of life’ is dependent upon them being content with the following aspects of their life: physical, psychological, emotional, social (and economic) and spiritual.

There can be many reasons for patients with wounds to feel isolated, lonely or that their quality of life experience has been negatively affected. In the same way that every wound and condition is different, so is every patient. Some patients feel that their wound reduces their quality of life. They may cite the following reasons:

The wound is painful and makes mobility difficult

The wound produces a lot of fluid and causes embarrassment if it makes bandages and/or clothing wet

Some wounds can produce odours which can also cause embarrassment as well as low self-esteem

Feeling that they are a burden to family and friends

Wounds can have a physical impact such as pain, odour, impaired mobility and sleepless nights, but they also have a social impact as patients may go out less often and see their friends and relatives less frequently. For those patients who are in employment, living with a wound means that they might potentially have to stop working, causing financial issues, as well as a feeling of loss of independence.

Living with a wound is not easy, but living with a patient with a wound can also be a challenge. Partners need to provide care, moral support and may need to contribute more financially if the patient can no longer work.

Exudate Pathway

Inappropriate management of exudate can lead to complexities including skin damage, pain and poor patient wellbeing. Healing is prolonged, placing a burden on patients’ and NHS resources. A knowledge and understanding of best practice regarding wound exudate, assessment and appropriate dressing selection is essential for effective management, good patient outcomes, as well as healthcare efficiency and productivity.

The 3M Exudate Pathway is an educational programme with a wide range of support tools to help increase knowledge and understanding of this best practice. The programme aims to help clinicians manage the problems behind exudate production and not just treat the symptoms.

Through offering a range of support tools the aim is to improve patient outcomes, decrease wound healing time, aid appropriate dressing selection, reduce wastage, help to educate staff and support clinicians in meeting relevant targets.

“A traumatic wound occurring on the extremities of older adults as a result of friction alone or friction and shearing forces which separates the epidermis from the dermis, or separates both the epidermis and the dermis from the underlying structures”

Skin tears are most common in people over the age of 65 due to the associated changes in elderly skin. The loss of collagen fibres leads to a loss of elasticity, flattening of the epidermal/dermal junction, reduced ability to counteract shearing forces and an increased risk of blistering all lead to an increased risk of skin tears. Although skin tear data in the UK is very limited, it is estimated that 360,000 skin tears occur each year in the UK. They tend to occur from minor traumas associated with bumping into objects, wheelchair injuries, transfers and falls but can also be caused by tightness of clothing, application or slippage of bandages, or low furniture.

The 3M Skin Tear Pathway aims to help clinicians to assess, plan and execute an appropriate management regime for the treatment of skin tears.